| NPI | 1679356406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 26096) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CO 989667) |
| 251S00000X Community/Behavioral Health (Licence: CA 26096) | |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2024-02-15 |